BACKGROUND In involuntary psychiatric admission, used globally, professionals or caretakers decide upon hospitalization regardless of what the person with psychosocial disabilities decides. This raises clinical, ethical, legal, and human rights concerns, and it goes against Convention on the Rights of Persons with Disabilities (CRPD). CRPD mandates that member states respect the autonomy of people with disabilities. Through Article 12, it recognizes full enjoyment of legal capacity for persons with disabilities. Implementation of Article 12 is challenging in every country, and exploring all the stakeholders' experiences at admission decision-making will help us to understand the challenges that the current psychiatry system poses for service users to exercise their autonomy and identify the areas where service users need support to have their rights, will, and preferences respected. AIM To describe the experiences of service users, informal carers, and professionals in involuntary psychiatric admission decision-making and throughout the subsequent involuntary admission. We explored the support that the service users need to have their rights, will, and preferences respected. METHOD A search of twelve databases in medicine, sociology, and law in Danish, English, Japanese, Norwegian, Portuguese, Spanish, and Swedish was conducted in 2017 and 2018, limited to the past 10 years, using terms such as "involuntary," "admission," "mental illness," and "experience". The search identified 682 articles. Four researchers independently reviewed the articles to find those that completed original qualitative or mixed method studies exploring experiences of involuntary psychiatric admission among adults. We added seven publications from the articles' references, contacted experts in the field (no publications were added), and excluded two articles that were in German. Three researchers analyzed the articles' results using Thematic Analysis (PROSPERO registration number CRD42019072874). RESULTS Overall, 37 articles were included from 11 countries; they involved 731 service users, 100 informal carers, and 291 mental health professionals. We identified a lack of communication and a power imbalance among the stakeholders, which was exacerbated by the professionals' attitudes. At admission decision-making, the service users wanted to be heard and wanted to understand the situation. The families felt responsibility for the service users, they were careful not to ruin relationships, and they struggled to obtain support from the mental health system. Professionals believed that threats or harming others should lead to admission regardless of what the service users or their families felt. Professionals sometimes felt that it was not necessary to explain the information to the service users because they would not understand. Professionals were concerned and frustrated with difficulties in coordinating among themselves. During admission, service users struggled with the ward environment and relationship with staff; they most objected to coercion, such as forced medication. Families were frustrated that they were not involved in the treatment planning, especially as the service users moved toward discharge. The professionals often rationalized that coercion was necessary, and they believed that they knew what was best for the service users. CONCLUSIONS A lack of communication and a power imbalance among the stakeholders hindered respect for the service users' rights, will, and preferences. This was exacerbated by professionals rationalizing coercion and assuming that service users were incapable of understanding information. Services that encourage communication and overcome power imbalances (e.g. Crisis Plans, Family Group Conferencing) combined with stronger community mental health support will respect service users' rights, will, and preferences and avoid substituted decision-making on issues such as involuntary admission and forced medication.

中文翻译：

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非自愿精神科住院决策的经验：对服务使用者，非正式护理人员和专业人员的观点进行系统的审查和综合。

背景技术在全球范围内使用的非自愿精神病院中，专业人员或看护人决定住院，而不考虑心理社会残障者的决定。这引起了临床，伦理，法律和人权方面的关注，并且违反了《残疾人权利公约》（CRPD）。CRPD要求成员国尊重残疾人的自治权。通过第十二条，它承认残疾人享有充分的法律行为能力。在每个国家/地区实施第12条都具有挑战性，并探索所有利益相关者的 入院决策方面的经验将帮助我们理解当前的精神病学系统对服务使用者行使其自主权构成的挑战，并确定服务使用者需要支持以尊重其权利，意愿和偏爱的领域。目的描述服务使用者，非正式护理人员和专业人员在非自愿精神病学入院决策以及随后的非自愿性入院过程中的经验。我们探索了服务用户需要尊重其权利，意愿和偏好的支持。方法在2017年和2018年（以过去10年为限），使用“非自愿”等术语对丹麦，英语，日语，挪威语，葡萄牙语，西班牙语和瑞典语的12个医学，社会学和法律数据库进行了搜索。 “入场券”，“ 专业人士的态度加剧了这种情况。在入场决策时，服务用户希望听到并希望了解情况。家庭对服务使用者感到责任，他们小心翼翼，不要破坏人际关系，并且他们努力地从心理健康系统中获得支持。专业人士认为，无论服务使用者或其家人感觉如何，威胁或伤害他人都应导致入院。专业人员有时认为没有必要向服务用户解释该信息，因为他们不会理解。专业人员对彼此之间的协调感到担忧和沮丧。入院期间，服务使用者在病房环境和与员工之间的关系上挣扎。他们最反对强迫，如强迫服药。家庭对他们没有参与治疗计划感到沮丧，特别是当服务使用者走向出院时。专业人士通常认为强制性是必要的，他们认为自己知道对服务用户最好的选择。结论利益相关者之间缺乏沟通和权力不平衡，阻碍了对服务用户权利，意愿和偏好的尊重。专业人员合理化强制并假设服务用户无法理解信息，这会加剧这种情况。鼓励交流和克服权力失衡的服务（例如危机计划，家庭小组会议）以及更强大的社区心理健康支持，将尊重服务使用者的权利，